Archive for July, 2008

Here’s an interesting article: published in the American Journal of Medicine this July. I bet after reading this article…you will have to review your old blood tests and determine if you are at risk to develop diabetes in the near future.

46,578 members of Kaiser Permanente Northwest who had fasting plasma glucose levels less than 100 mg/dL between January 1, 1997, and December 31, 2000, and who did not previously have diabetes or impaired fasting glucose.

Subjects developed diabetes at a rate of less than 1% per year during a mean follow-up of 81.0 months.

Compared with those with fasting plasma glucose levels less than 85 mg/dL, subjects with glucose levels of 95 to 99 mg/dL were 2.33 times more likely to develop diabetes (HR 2.33; 95% CI, 1.95-2.79; P < .0001).

Subjects in the 90 to 94 mg/dL group were 49% more likely to progress to diabetes (HR 1.49; 95% CI, 1.23-1.79; P <.0001).

All other risk factors except sex were significantly associated with a diabetes diagnosis.

Conclusions

The strong independent association between the level of normal fasting plasma glucose and the incidence of diabetes after controlling for other risk factors suggests that diabetes risk increases as fasting plasma glucose levels increase, even within the currently accepted normal range.

This study although with limitations sends a strong signal that everytime one gets an executive panel test.. a thorough evaluation has to be made from the numbers that will give us SIGNALS of future disease risk. There is no room for saying that the results are borderline or of no significance because waiting fo the sugar to be abnormal before one recommends action is tantamount to negligience!

Targeting out patients early means preventing onset of the the disease resulting in lesser chances of developing chronic complications which can be disabling and costly!

Lifestyle changes will continue to be the mainstay for these patients with sugars within the normal range but are at the highest risk to develop diabetes in the next few years! A little sacrifice can do a long way in preventing illness and promoting health!

Get hold of your last years blood tests…look at the numbers…is your blood suagr 97 mg/dl? Then be aware that you are at risk to develop diabetes in the near future… and therefore DO SOMETHING!!!! Lose weight, take care of what you eat and MOVE!

As I was preparing for the things to bring on my trip to Hawaii thia afternoon, I felt the urge to eat something. And what I found inside my fridge were 6 apples. Being the favorite fruit of my second child, I always make sure there are apples for her to eat after each meal. So there I was, eating on apple with the SKIN and slowly feeling satisfied and full! Boy, was it nice, and healthy….

So I though of leaving you something nice about apple.

Definitely the saying: “An apple a day keeps doctors away” was true all along as more studies have found out that apples have plenty of vitamins and minerals, as well as phytonutrients especailly the flavonoids called quercetin, which has high antioxidant activity. Likewise apples are high in fiber and potassium, and contain no fat or salt.

The UC Davis Department of Internal Medicine study showed that “not only do apples and apple juice contain a variety of phytonutrients, but that making apples a regular part of the diet may translate into real health benefits”. Eating apples in that study showed reduced oxidation indicators and a 22-percent increase in dietary fiber.

Other studies have also shown that individuals who regularly incorporated apples into their diet cut their lung cancer risk in half. lower the risk for stroke, reduce the growth of colon cancer and liver cancer cells with just two-thirds of a medium apple!!!!!

Lastly… dont peel the skin when eating apple. It is said that most of the fiber and antioxidants are in the peel. Contrary to popular belief…laboratories have consistently shown that the skin of apples contain very low levels of pesticides….So they’re SAFE to eat!!!!

This new study again refutes what has been said about the low carb hype.

We all know the breakfast is an important meal. In this website, I have emphasized that skipping breakfast equals weight gain equals metabolic syndrome. Therefore it is a must that we all have to break the fast to maintain our weight and be healthy.

The low-carb diet allowed 1,085 calories a day with 17 grams of carbohydrates, 51 grams of protein, and 78 grams of fat. Breakfast for members of this group was to be 290 calories with 7 grams of carbohydrates and 12 grams of protein.
The modified form of this diet allowed 1,240 calories a day with less total fat (46 grams) but more carbs (97 grams) and protein (93 grams). The main feature was a 610-calorie “big breakfast” accounting for about half of the daily carbohydrates (58 grams), protein (47 grams), and fat (22 grams).

During the first 16-week weight-loss phase, the big-breakfast group lost about the same amount of weight as the low-carb group (10.6 kg versus 12.6) with no significant difference between groups.

During the following 16-week maintenance phase, though, the groups’ experience diverged. The big-breakfast group continued losing weight and reached an average 21.3% weight loss by the end of the trial (18.1 kg below baseline).

The low-carb group, on the other hand, regained much of the weight lost to end at just 4.5% below baseline (4.3 kg). The protein- and carbohydrate-heavy breakfast appeared to regulate hunger cues, the researchers said.

Visual analog scale scores after breakfast for the two groups were improved with the big-breakfast diet compared with the low carb diet for the following:

Hunger (P=0.018)

Feeling of still being able to eat a lot more food (P=0.001)

Fullness (P=0.001)

Satiety (P=0.07)

The difference in fullness extended beyond lunch and through 11 p.m. (P=0.001).

This study suggests that having a heart high carb and high protein breakfast translates to lesser craving for sweets and lesser hunger. Again as we emphasized in any weight loss counseling, it is not recommended that patients trying to lose weight are on a dietary regimen that makes them feel hungry.

This is one study that I will wait for the final posting in a peer reviewed journal. It would be nice to see how the study was conducted and see where the flaws could be and whether this can be translated into clinical practice.

One of the many aspects in life that we desire is to be happy in all areas of our daily activities…and that includes nighttime responsibilities of a husband to the partner! And what comes worst is the problem of impotence or erectile dysfunction due to medical diseases like diabetes or non medical like psychological in nature…being the most common cause.

Now comes a very interesting piece of information for all of us! This study on how we can prevent the problem of poor sex life due to erection problems was recently published in the American Journal of Medicine, July 2008.

Background

Erectile dysfunction is common among men aged more than 60 years. Its cause involves both physiologic and psychosocial factors.

Methods

Data were analyzed from a population-based 5-year follow-up study that was conducted in Pirkanmaa, Finland, using postal questionnaires. The study sample consisted of 989 men aged 55 to 75 years (mean 59.2 years).

Results

The overall incidence of moderate or complete erectile dysfunction was 32 cases per 1000 person-years (95% confidence interval [CI], 27-38). After adjustment for comorbidity and other major risk factors:

men reporting intercourse less than once per week at baseline had twice the incidence of erectile dysfunction compared with those reporting intercourse once per week (79 vs 33/1000, incidence rate ratio 2.2, 95% CI, 1.3-3.8).

The risk of erectile dysfunction was inversely related to the frequency of intercourse.

No relationship between morning erections and incidence of moderate or severe erectile dysfunction was found.

Conclusion

Regular intercourse protects against the development of erectile dysfunction among men aged 55 to 75 years.

This may have an impact on general health and quality of life; therefore, doctors should support patients’ sexual activity.

Yes…I fully support my patients sexual activity because I know it is a very important cause of depression among my diabetic patients. In fact this is one of the reasons why I am very aggressive in treating my diabetic patients especially if they are also hypertensives because I want them to preserve the fun of sex and avoid the problem of impotence later in life.

So doing it more frequently is the way to go!!!! What a fun way to prevent a disease… the more the better…

It seems more prevalent the older the patient gets but seems to be more common among my diabetic nowadays. And my suspicion is right based on a new article published in the Annals of Internal Medicine, July issue:

Results: 5140 noninstitutionalized adults age 20 to 69years who had audiometric testing.

Hearing impairment was more prevalent among adultswith diabetes. Age-adjusted prevalence of low- or mid-frequencyhearing impairment of mild or greater severity in the worseear was 21.3% (95% CI, 15.0% to 27.5%) among 399 adults withdiabetes compared with 9.4% (CI, 8.2% to 10.5%) among 4741 adultswithout diabetes.

Similarly, age-adjusted prevalence of high-frequencyhearing impairment of mild or greater severity in the worseear was 54.1% (CI, 45.9% to 62.3%) among those with diabetescompared with 32.0% (CI, 30.5% to 33.5%) among those withoutdiabetes.

Conclusion: Hearing impairment is common in adults with diabetes,and diabetes seems to be an independent risk factor for thecondition.

The more likely explanation to this complication is still diabetes related microcirculation abnormality which is seen in other organs affected by this condition. Whether tight control of blood glucose can help prevent the onset and progression of this condition remains to be seen.

Still the same, good control has been shown to help prevent circulatory problems of the affected organs in the body such as the eyes and the kidneys….and therefore there should be no reason why the same wont hold true to the cochlea.

This study therefore helps us realize that patients with diabetes should probably start screening for hearing impariment so as to avoid exposure to unnecessary factors that can help aggravate the condition like noise pollution, loud music and some drugs that have been shown to cause hearing loss.